NACDS’ Anderson: ‘National curiosity’ also needed to solve opioid abuse crisis
You may have seen the news this week about an interim report of the President’s Commission on Combating Drug Addiction and the Opioid Crisis. The Commission — chaired by Governor Chris Christie — included among its initial recommendations one that it describes as “first and most urgent”: declaring a national emergency on this issue. The Commission explained that bringing this type of intensity to the effort would have specific ramifications for funding and resource allocation, as well as awakening every American to the risks associated with drug abuse and addiction.
Pharmacy — including actions of NACDS specifically — maintains a long-standing commitment to developing and implementing solutions on this extremely challenging topic. In July, NACDS submitted comments to the Commission that describe this commitment, as well as specific views on new opportunities to improve the nation’s approach to addiction, abuse and diversion.
This is a topic on which NACDS has been engaged for a long time, and with tremendous concern for patients and for the pharmacy teams who serve them in every neighborhood across the country. There is often talk of the moment of truth that occurs at a pharmacy, when an individual arrives to have a prescription filled for a controlled substance. At that moment of truth, pharmacies and pharmacists often are caught in the middle of highly complex issues related to patient care, healthcare access, addiction, abuse, diversion.
In May 2015, an NACDS op-ed in the Tampa Bay Times put it this way: “The pharmacy counter … is where the patient ultimately is receiving either a ‘yes’ or a ‘no’ as to whether the prescription will be filled. However, pursuing a zero tolerance for drug abuse and a 100-percent commitment to patient care — at the same time — requires collaboration that reaches far beyond that interaction between a patient and a pharmacist.”
Whatever policy changes are ultimately made — with the active engagement of the pharmacy community and with diverse stakeholders — we are urging that they be pursued with a new level of national curiosity that gets to the essence of these complex issues like never before. It has been said that one needs to ask the question “why” between five and seven times to get to the heart of any matter, and to more fully understand dilemmas and potential solutions alike. Many amazing minds have applied their wisdom and experience to addiction and abuse issues over the course of many years. However, I think many observers would agree that our nation has not yet completely applied the curiosity necessary to transcend what is politically possible to arrive at deeper and more comprehensive solutions.
The pursuit of collaboration — and the curiosity necessary to find real solutions — was a driving force behind the Ensuring Patient Access and Effective Drug Enforcement Act of 2016, which was enacted on April 19, 2016. Among its provisions, the law requires that the U.S. Department of Health and Human Services submit a report to Congress, based on extensive collaboration with other agencies and stakeholders, that describes opportunities for better integration to achieve common goals related to opioids.
As the President’s Commission on Combating Drug Addiction and the Opioid Crisis continues its work, NACDS will help to foster and respond to the national curiosity that is necessary to create real solutions to the national emergency that we face. NACDS will do this while keeping focused on what has guided our efforts all along – the good of the American public and the pharmacy team members who serve them.
Steve Anderson is the president and CEO of the National Association of Chain Drug Stores.
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Gilead’s Epclusa gets expanded indication
SILVER SPRING, Md. — Gilead Sciences’s Epclusa single-tablet hepatitis C treatment this week got approval from the Food and Drug Administration for an expanded indication. The drug is now approved for use in patients with hepatitis C that are co-infected with HIV.
“HCV co-infection remains a major cause of morbidity in HIV-infected individuals,” said Dr. David Wyles, Denver Health Medical Center’s infectious disease division president said. “With this expanded use, Epclusa provides co-infected patients with a much needed one-pill-a-day regimen that works across all HCV genotypes and is compatible with widely-used antiretroviral regimens. … With Epclusa, physicians have an important new treatment option for their HCV/HIV co-infected patients.”
Epclusa carries a boxed warning about the risk of hepatitis B virus reactivation in co-infected patients. The FDA approved the drug in 2016 to treat adults with genotype 1-6 chronic HCV infection without cirrhosis or with compensated cirrhosis, or with decompensated cirrhosis in combination with ribavirin.